The invention relates to a dental diagnostic system and method for analyzing tooth structure, restorative materials within a tooth structure, and disease states of a tooth.
In some regards, modern dentistry has become quite complex. Some aspects of dental technology have changed with improvements and greater acceptance of orthodontics, endodontics, advanced oral surgery techniques, and geriatric patients. These improvements, coupled with greater public awareness and public demand to keep their teeth, requires that the skills of dental practitioners continue to be enhanced.
Diagnostics is one such area in dentistry in which enhanced skills continue to be needed. However, the prior art has not been forthcoming in making diagnostic advances.
Take, for example, the main dental diagnostic tool, the common dental explorer or probe. This mainstay in dental technology for diagnosing caries, has not changed for 150 years. It is of the same design now as it was in the last century.
The prior art has recognized that teeth have a characteristic electrical conductance. P. Pincus described such findings in a publication of the xe2x80x9cProceedings of the Physiological Society,xe2x80x9d in the Dec. 15-16, 1951 issue. His paper and findings are entitled, xe2x80x9cA New Method of Examination of Molar Tooth Grooves for the Presence of Dental Caries.xe2x80x9d He indicated that human tooth enamel consisted of 95% lime salt and is an extremely poor conductor of electricity, and that breaks in continuity might result from cracks, hairline fractures, developmental faults and non-calcified organic material.
Efforts have been made to exploit this electrical conductance characteristic. U.S. Pat. No. 4,537,573 to Sunada, entitled xe2x80x9cDetector For Diagnosing Dental Caries,xe2x80x9d discloses that through the use of a hand held apparatus applying a 400 Hz signal, a dentist can jointly contact a tooth with a probe and watch the detector indicator lights, to find an indication of the quality of tooth structure.
U.S. Pat. No. 4,955,810 to Levy, entitled xe2x80x9cDentin Thickness Monitorxe2x80x9d is similar to Sunada, but has a more complex electric circuitry that includes operational amplifiers, logic circuitry, and a host of discriminating LEDs.
U.S. Pat. No. 3,753,434 to Pike, entitled xe2x80x9cElectronic Device for Measuring Penetration Of Tooth Root Canal And Endodontic Therapy Method,xe2x80x9d is for the use of an electronic device for accurately determining the point of penetration of root canal and contacting periodontal tissue with a oscillating measuring signal. Such systems are limited in that they are based primarily on detection of the precise end of a root, and as such as calibrated to determine when the dental instrument is within 3 mm from the end of the tooth.
Similar to Pike is U.S. Pat. No. 4,353,693 to Dery, entitled xe2x80x9cApparatus for the Determination and Digital Display of the Position of Root Treating Means in a Tooth,xe2x80x9d which device measures AC conductivity.
U.S. Pat. No. 5,049,069 to Salesky, entitled xe2x80x9cDigital Apical Foramen Locating Apparatus with Linear Graphing,xe2x80x9d pertains to the endodontic specialty. Salesky teaches to recognize that the conductance from the apical foramen to a patient""s lip is equal to the conductance from the sulcus to the lip and is further constant from patient to patient.
Root canal length measuring devices have also been disclosed in U.S. Pat. No. 3,916,529 to Mousseau, xe2x80x9cMethod of and Instrument for Determining Length of Root Canal . . . . xe2x80x9d
Transillumination, or the use of reflecting light through a tooth to determine decay, is disclosed by Hibst, U.S. Pat. No. 5,306,144.
The prior art has provided devices with visual and audible interpretation of treatment through which the operator may monitor the progress of the clinical case. However, the prior art have not gained wide acceptance and suffer from various problems, e.g., they show indicator lights attached directly to the head of the dental handpiece. This position for the lights turns out to be impractical. For example, repeated sterilization of the dental handpiece adversely affects indicator lights and renders the indicator panel non-functional in a rather short period of time.
In the prior art, when determining inter-proximal decay the dental practitioner has had to rely on x-rays or clinical examination to detect caries in these locations. Current methods of clinical examination includes visualization and touch with the explorer. Both, however, can give false information. X-rays have been considered state of the art, but do not allow for early detection of incipient lesions. For example, leakage around the periphery of a filling can not always be checked adequately with these methods. Further, these methods have not always proved satisfactory as to ascertaining the quality of tooth structure in all types of cavities, including Class I, II, III, IV, V, VI, and some types not classified in these groups such as crown margin caries, and intracanal caries.
Although the current method of choice in dentistry to diagnose inter-proximal decay is with x-rays or radiographic interpretation, even given ideal circumstances, it has been shown that x-ray diagnosis is correct only about 30% of the time. Indeed, these methods are difficult for the inexperienced practitioner to achieve success as it generally requires years of clinical experience to master x-ray interpretation.
An overall objective of the invention is to provide a system and method which improves the diagnostic capability of the dental practitioner utilizing a single-multi-functional device.
Another object of the invention is to provide a system and method to supply adjunctive information by which the dental practitioner may make a better decision regarding treatment alternatives.
Yet another object of the invention is to provide a method of determining if teeth or tooth structure is cracked, from disease or overloading; locating perforations through a tooth during root canal therapy, or during restorative procedures; determining key locations to place pins so as to select areas that will minimize the chance of cracking the tooth, or to minimize the possibility of causing nerve damage; determining, once a pilot hole has been made, whether a frank opening into the nerve has inadvertently been made; testing sealants for leakage or decay; and identifying hidden pit caries.
Still another object of the invention is to provide a diagnostic analyzer device having a lead which can be attached to an instrument being used to treat the patent, without distraction to the treatment, and having a audible results output monitor through which the dental practitioner can hear decay being removed by providing a compactly sized device which has easy portability and direct attachment to an appropriate dental handpiece, a dental explorer, or other suitable intraoral dental instrument/probe.
In another respect, the invention has as an object to provide a system for establishing objective readings or findings which can be used as a baseline recorded in a patient""s chart for future comparisons.
For a further object of the invention, there is the object of addressing a pulp exposure situation by providing a system and method of finding the approximate outline of nerve so that adequate nerve coverage is provided to prevent post-operative sensitivity.
The invention has as an additional object providing a device which can be used to help differentiate between enamel, dentin, sclerotic dentin, reparative dentin, thin or weak dentin, carious pulp exposures, iatrogenic pulp exposures, perforations, major canals, accessory canals, cracks, fissures, craze lines (and their length, direction and potential for problematic cause).
Another further object of the invention is providing a device and method of monitoring an isolated area, e.g., one that has been covered by a dental rubber dam.
A more further object of the invention is to provide a method to determine if a filling material, base or cement had been adequately cured or sealed, prior to conclusion of a treatment.
One more object of the invention is to obviate the need for x-rays and the such to diagnose interproximal decay.
Further objects and benefits of the invention will become clear from the following disclosure.